Tennis Elbow

What is tennis elbow?

A tendon is a tough cord of tissue that connects muscles to bones. The tendon most likely involved in tennis elbow is called the exterior carpi radialis brevis. Tennis elbow is usually diagnosed in both men and women between ages 30 to 50.

What causes tennis elbow?

Tennis elbow, as the name implies, is often caused by the force of the tennis racket hitting balls in the backhand position. Your forearm muscles, which attach to the outside of your elbow, may become sore from excessive strain. When making a backhand stroke in tennis, the tendons that roll over the end of our elbow can become damaged. Tennis elbow may be caused by:

Improper backhand stroke

Weak shoulder and wrist muscles

Using a tennis racket that is too tightly strung or too short

Other racquet sports, like racquetball or squash

Hitting the ball off center on the racket, or hitting heavy, wet balls

However, many people who suffer from tennis elbow do not play tennis. The problem can be caused by any repetitive movement. Other causes of tennis elbow include:

Painting with a brush or roller

Working a chain saw

Frequent use of other hand tools on a regular basis

Using repeated hand motions in various types of work, such as butchers, musicians, dentists, and carpenters

What are the symptoms of tennis elbow?

The following are the most common symptoms of tennis elbow. However, you may experience symptoms differently.

At first, you may have pain, burning, or an ache along the outside of your forearm and elbow. With time, the pain gets worse. If you continue the activity that caused your condition, the pain may spread down to your wrist, even at rest. Pain may also persist when you place your arm and hand palm-down on a table, and then try to raise your hand against resistance. You may also feel pain when you try to lift and grip small objects, such as a coffee cup. A weak grip is another symptom of tennis elbow.

The symptoms of tennis elbow may look like other medical problems or conditions. Always see your healthcare provider for a diagnosis.

How is tennis elbow diagnosed?

Your healthcare provider can usually diagnosis your tennis elbow with a physical exam. In some cases, you may have certain tests, such as:

An X-ray to look at the bones of your elbow to see if you have arthritis in your elbow.

MRI can show your tendons and the amount of damage. An MRI of your neck can show if arthritis is in your neck, or disk problems in your spine are causing your arm pain.

Electromyography (EMG) of your elbow may show if you have any nerve problems that may be causing your pain.

How is tennis elbow treated?

It’s important to avoid the movement that caused your injury in the first place. Treatment may include:

Rest and stopping the activity that produces the symptoms

Ice packs to reduce inflammation

Strengthening and stretching exercises

Anti-inflammatory medicines such as ibuprofen or naproxen

If these treatments don't work, your healthcare provider may talk to you about:

Bracing the area to keep it still for a few weeks or use of a special brace with activities

Steroid injections to help reduce swelling and pain

A special type of ultrasound that can help break up scar tissue, increase blood flow, and promote healing

Surgery is rarely necessary

What can I do to prevent tennis elbow?

Keep your arms flexible and strong.

Stay away from repetitive movements.

Warm up before exercising or using your arms for sports or other repetitive movements.

If you play a racquet sport, make sure your equipment is right for you.

When should I call my healthcare provider?

Call your healthcare provider if you have any of the following:

Pain or trouble moving affects your daily activities

Pain doesn’t get better or it gets worse with treatment

You see a bulge or lump on your arm

Key points about tennis elbow

Tennis elbow is swelling or tearing of the tendons that bend your wrist backward away from your palm.

It’s caused by repetitive motion of the forearm muscles, which attach to the outside of your elbow. The muscles and tendons become sore from too much strain.

Symptoms include pain, burning, or an ache along the outside of the forearm and elbow. It gets worse and may spread down to the wrist if the person continues the activity that causes the condition. The grip may become weak.

Tennis elbow can be treated with rest and medicines to help with the inflammation. Exercises often help too. Rarely, surgery may be done to repair the tendon.

You can help prevent tennis elbow by doing things like warming up before exercise or sports, increasing activity slowly, using the right equipment for activities, and strengthening your arm muscles.

Next steps

Tips to help you get the most from a visit to your health care provider:

Know the reason for your visit and what you want to happen.

Before your visit, write down questions you want answered.

Bring someone with you to help you ask questions and remember what your provider tells you.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

Ask if your condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if you do not take the medicine or have the test or procedure.

If you have a follow-up appointment, write down the date, time, and purpose for that visit.